March 2019 Volume LIV Number 2

Building Dental Homes for All of Our Children

The young child with the enormous eyes stared up at the volunteer who had just assisted in pulling several of his badly decayed teeth, "Can I come home with you?" he asked.

Not used to such questions, the volunteer replied, "I don't think so. Your dad would miss you too much".

The child replied, "My father is dead".

The volunteer hid his shock and said, "What about your mom? I am sure she would miss you".

"No, she's dead, too."

Reality set in for the volunteer as he looked across the clinic and realized that this was the story for most of the little patients seeking treatment. This is Mildmay Uganda Clinic in Africa and many of these patients are orphans and may be the head of their household by the age of 12 or 13. The majority have been infected or affected by HIV/AIDS.

Dental homes for children in third-world countries do not exist without the love and support of many; but, the driving force behind this clinic is Dr. Paul Musherure, a pediatric dentist from St. Paul, Minn. A humble man with an enormous heart, Musherure serves children in the United States at Health Partners St. Paul Dental Clinic. Being a native Ugandan, however, he was well aware of the need back in his home country.

Musherure came to Michigan from Uganda in 1988 to pursue his dental education. In Africa, he had practiced as a public health dental officer and realized not only his love for the profession of dentistry but also the desire to serve children. At that time, the HIV/AIDS epidemic was spreading throughout his country and taking an enormous toll on its people. He wanted to help.

Musherure still has strong family ties in Uganda and this year decided that his own children need to understand the heritage and culture of the country. His wife and children will be staying in Uganda for two years and Musherure will commute between Minnesota and Uganda. It is not an easy commute, requiring over 24 hours of travel time—and that's if every flight is on schedule.

The Mildmay Center in Kampala, Uganda, is open year round. The dental mission, however, takes place for just two weeks in late January and began in 2003 after Musherure met Dr. John Sexton, a pediatric dentist from Colorado, at a dental meeting in Denver. Sexton invited Paul to volunteer for a mission trip to Romania in June, 2003, where Sexton had a ministry to children in orphanages. Many of those children were infected with HIV/AIDS. Musherure agreed only under the condition that Sexton would join him in Uganda to explore the possibility of a similar mission trip there. That promise was honored and they along with six others visited Uganda to assess the needs. In February 2004, the mission trip began with a team of 16 people and Musherure has led similar teams each year since.

The dental mission, or, as Musherure refers to, it "Minnesota Uganda Dental Mission" is located in the Mildmay Clinic for several reasons. Musherure's brother and sister, who still live in Uganda, are friends with the director of Mildmay International which is a Christian-based pioneering HIV charity. Mildmay first began in England but also works in sub-Saharan Africa and eastern Europe to deliver quality care and treatment and training. The medical and organizational support through the Mildmay hospital was a perfect fit for Musherure's dental clinic.

This year Mildmay celebrated a 10-year partnership with the Center of Disease Control. This anniversary and the 10th anniversary of the dental mission trip were recognized in ceremonies this year by Scott DeLisi, the U.S. Ambassador to Uganda.

Each day begins with chapel and lets the volunteers reflect on the day ahead which will be filled by children with serious dental needs. It will be an exhausting day but rewarding in ways that are inexplicable. These are children that have traveled for hours by bus while others walk. The children arriving for the first time are scared and some crying; others who have been to the clinic before are less afraid and eager to ride the donated bikes or sing songs and do crafts with the volunteers. The wait for these young patients is not brief and may last for several hours. In their brief time in Uganda, the volunteers will see over 400 patients.

Communication can be a challenge, but interpreters help. One volunteer remembers the child who was terrified on the first visit and because of the extent of the needed work had to make two more return trips. The final visit found the youngster requesting a specific volunteer and singing along with them. Each child will leave with not only a healthier smile but also with a school bag including school supplies, an article of clothing and their favorite, which is photograph of themselves. The clinic is scheduled in January because it coincides with the beginning of the Ugandan school year.

Most of the children have numerous dental needs complicated by severe systemic medical conditions. Almost all have HIV/AIDS. Their medical forms are basic questions. "Do you have AIDS, tuberculosis or malaria? Are you being treated for them?" Many do not know the answers. A full range of dental services are provided although there are many large restorations, chrome steel crowns and extractions. Much emphasis is placed on prevention and each child receives home care instructions and a toothbrush. Over 400 children received treatment in two weeks, but sadly many more will have to wait until next year.

The clinic would not happen without Musherure, who is already preparing for next year's mission trip, gathering supplies and working hard to find ways to replace some of the equipment that is in desperate need of replacement. Musherure was one of ten people recognized last December by the Ugandan Embassy in Washington, D.C., as a part of the country's 50th anniversary of their independence. He was recognized for the service he has provided to his native country; but, while he appreciates the award, he minimizes the recognition. He will quickly tell you that it is not as important as the children, "his children" that he serves.

While Musherure encourages dentists in the Minnesota region to join the mission trip there are dentists from other states involved as well. The trip is sponsored through the African Christian Fellowship of Minnesota in St. Paul and the Crossroads Church in Woodbury, Minn. While dental care is the primary goal, sharing the love of Jesus and a children's ministry including play, storytelling crafts and gifts are also important components.

Supplies are donated or bought at a discount from World Dental Relief. The monetary needs are met by anonymous private donations, the church Musherure attends and the Patterson Dental Foundation. Every November, prior to the mission trip, volunteers gather in the Minneapolis area to pack all of the supplies and ready them for shipment to Africa. The cost to ship the supplies to Uganda will be more than $7,000.

Most of the dentists that participate are pediatric dentists, however, there have been a few general dentists and at least one oral surgeon during the past 10 years. Some bring their own assistants to be more efficient and safe, but there are assistants that volunteer and come on their own. Some of the key personnel that make this trip possible are not dentists and not from Minnesota. They provide the much needed maintenance of the well-used equipment which is donated and stored at the Mildmay center.

Equipment is retrieved from storage and set up on the first day of each mission trip by all the volunteers in an old Mildmay classroom.

Keeping this equipment running is primarily the responsibility of two individuals, Bob Witt and Jim McMenimen, who have been involved in every one of Musherure's mission trips as well as those Sexton took to Romania. Witt received his training on the repair of dental equipment in his garage by Patterson servicemen.

In the 10 years since the clinic opened there have been changes in the children. The children, according to Musherure, are stronger and fewer young children are forced to be the head of the household because both parents have died from HIV/AIDS. There appear to be more normal, healthy children. He is amazed by the continuation of the program which relies on the outpouring of gifts including time, talent and money to survive.

"The need is enormous and it is by the Grace of God that they come 4,000 children have seen a difference in their lives as a result of those that have given to the mission," he said. The end of each trip tugs on the hearts of those that have volunteered and on Musherure. His compassion is evident as he emotionally thanks everyone for their efforts and for "taking care of his children". The children, however, have become a part of each volunteer and they are now "their children" too. The experience is life changing for everyone involved.